In vitro and in situ activation of the complement system by the fungus Lacazia loboi

Since there are no studies evaluating the participation of the complement system (CS) in Jorge Lobo's disease and its activity on the fungus Lacazia loboi, we carried out the present investigation. Fungal cells with a viability index of 48% were obtained from the footpads of BALB/c mice and incubated with a pool of inactivated serum from patients with the mycosis or with sterile saline for 30 min at 37 ºC. Next, the tubes were incubated for 2 h with a pool of noninactivated AB+ serum, inactivated serum, serum diluted in EGTA-MgCl2, and serum diluted in EDTA. The viability of L. loboi was evaluated and the fungal suspension was cytocentrifuged. The slides were submitted to immunofluorescence staining using human anti-C3 antibody. The results revealed that 98% of the fungi activated the CS by the alternative pathway and no significant difference in L. loboi viability was observed after CS activation. In parallel, frozen histological sections from 11 patients were analyzed regarding the presence of C3 and IgG by immunofluorescence staining. C3 and IgG deposits were observed in the fungal wall of 100% and 91% of the lesions evaluated, respectively. The results suggest that the CS and immunoglobulins may contribute to the defense mechanisms of the host against L. loboi

Análise geoestatística de casos de hanseníase no Estado de São Paulo, 1991-2002

OBJETIVO: Analisar o padrão espacial da ocorrência dos casos de hanseníase para identificar áreas com probabilidade de riscos de transmissão da doença. MÉTODOS: Estudo ecológico, tendo como unidade de análise os municípios do Estado de São Paulo georreferenciados em seus centróides. A fonte de dados utilizada foi o banco informatizado dos casos de hanseníase notificados do Centro de Vigilância Epidemiológica do Estado de São Paulo, no período de 1991 a 2002. Utilizou-se de técnicas de geoestatística para a detecção das áreas de probabilidade de risco para hanseníase e quantificação da dependência espacial dos casos. RESULTADOS: Detectou-se o alcance de dependência espacial de 0,55 graus de coordenadas georreferenciadas, correspondendo aproximadamente a 60 km. As principais áreas de probabilidade de risco encontradas foram as regiões nordeste, norte e noroeste do Estado. CONCLUSÕES: A verificação de áreas com probabilidades de riscos de casos de hanseníase, utilizando-se a análise da dependência espacial, pode ser ferramenta útil para avaliar a situação de saúde e planejar alocação de recursos.OBJECTIVE: To analyze the spatial pattern of leprosy case occurrences in order to identify areas with a probability of disease transmission risks. METHODS: This was an ecological study in which the analysis units were municipalities in the State of São Paulo that were georeferenced at their centroids. The data source was the electronic database of notified leprosy cases at the Epidemiological Surveillance Center of the State of São Paulo, from 1991 to 2001. Geostatistical techniques were used for detecting areas with a probability of leprosy risk, and for quantifying the spatial dependency of cases. RESULTS: The spatial dependence detected extended outwards to 0.55 degrees from the georeferenced coordinates, which corresponded to approximately 60 km. The main areas identified as presenting a probability of risk were the northeastern, northern and northwestern regions of the State. CONCLUSIONS: Verification of areas with the probability of leprosy risk using spatial dependence analysis may be a useful tool for assessing health conditions and planning budget allocations

Análise geoestatística de casos de hanseníase no Estado de São Paulo, 1991-2002

OBJETIVO: Analisar o padrão espacial da ocorrência dos casos de hanseníase para identificar áreas com probabilidade de riscos de transmissão da doença. MÉTODOS: Estudo ecológico, tendo como unidade de análise os municípios do Estado de São Paulo georreferenciados em seus centróides. A fonte de dados utilizada foi o banco informatizado dos casos de hanseníase notificados do Centro de Vigilância Epidemiológica do Estado de São Paulo, no período de 1991 a 2002. Utilizou-se de técnicas de geoestatística para a detecção das áreas de probabilidade de risco para hanseníase e quantificação da dependência espacial dos casos. RESULTADOS: Detectou-se o alcance de dependência espacial de 0,55 graus de coordenadas georreferenciadas, correspondendo aproximadamente a 60 km. As principais áreas de probabilidade de risco encontradas foram as regiões nordeste, norte e noroeste do Estado. CONCLUSÕES: A verificação de áreas com probabilidades de riscos de casos de hanseníase, utilizando-se a análise da dependência espacial, pode ser ferramenta útil para avaliar a situação de saúde e planejar alocação de recursos.OBJECTIVE: To analyze the spatial pattern of leprosy case occurrences in order to identify areas with a probability of disease transmission risks. METHODS: This was an ecological study in which the analysis units were municipalities in the State of São Paulo that were georeferenced at their centroids. The data source was the electronic database of notified leprosy cases at the Epidemiological Surveillance Center of the State of São Paulo, from 1991 to 2001. Geostatistical techniques were used for detecting areas with a probability of leprosy risk, and for quantifying the spatial dependency of cases. RESULTS: The spatial dependence detected extended outwards to 0.55 degrees from the georeferenced coordinates, which corresponded to approximately 60 km. The main areas identified as presenting a probability of risk were the northeastern, northern and northwestern regions of the State. CONCLUSIONS: Verification of areas with the probability of leprosy risk using spatial dependence analysis may be a useful tool for assessing health conditions and planning budget allocations

Refractive errors in a Brazilian population: age and sex distribution

PurposeTo determine the prevalence of refractive errors and their distribution according to age and sex in a Brazilian population.MethodsThis population-based cross-sectional study involved 7654 Brazilian inhabitants of nine municipalities of Sao Paulo State, Brazil, between March 2004 and July 2005. Participants aged >1year were selected using a random, stratified, household cluster sampling technique, excluding individuals with previous refractive or cataract surgery. Myopia was defined as spherical equivalent (SE) -0.5D, high myopia as SE -3.0D, hyperopia as SE +0.5D, high hyperopia as SE +3D, astigmatism as -0.5DC and anisometropia as 1.0D difference between eyes. Age, sex, complaints and a comprehensive eye examination including cycloplegic refraction test were collected and analysed using descriptive analysis, univariate and multivariate methods.ResultsThe prevalence of astigmatism was 59.7%, hyperopia 33.8% and myopia was 25.3%. Astigmatism had a progressive increase with age. With-the-rule (WTR) axes of astigmatism were more frequently observed in the young participants and the against-the-rule (ATR) axes were more frequent in the older subjects. The onset of myopia occurred more frequently between the 2nd and 3rd decades of life. Anisometropia showed a prevalence of 13.2% (95% CI 12.4-13.9; p<0.001). There was an association between age and all types of refractive error and hyperopia was also associated with sex. Hyperopia was associated with WTR axes (odds ratio 0.73; 95% CI: 0.6-0.8; p<0.001) and myopia with ATR axes (odds ratio 0.66; 95% CI: 0.6-0.8; p<0.001).ConclusionsAstigmatism was the most prevalent refractive error in a Brazilian population. There was a strong relationship between age and all refractive errors and between hyperopia and sex. WTR astigmatism was more frequently associated with hyperopia and ATR astigmatism with myopia. The vast majority of participants had low-grade refractive error, which favours planning aimed at correction of refractive error in the population.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Distribuição espacial de doenças endêmicas no município de Ribeirão Preto (SP) Spatial distribution of endemic diseases in Ribeirão Preto, São Paulo State

A percepção de que algumas doenças acontecem em determinados lugares é antiga. A preocupação em estudar as relações entre o homem e o meio resultou em diversos trabalhos de geografia médica, voltados à análise da distribuição espacial das doenças. Este estudo seccional foi desenvolvido no município de Ribeirão Preto (SP) e teve como objetivo ilustrar, por meio de agravos de saúde (dengue, hanseníase e tuberculose), de que forma uma ferramenta de um sistema de informação geográfica permite a identificação de áreas heterogêneas, fornecendo subsídios para a escolha de estratégias e intervenções específicas de acordo com a necessidade dos moradores, bem como a priorização de recursos para grupos mais vulneráveis. A população compreendeu os casos de dengue, hanseníase e tuberculose notificados no ano 2000 em Ribeirão Preto. Os dados foram coletados na Vigilância Epidemiológica da Secretaria Municipal de Saúde do município. Para a obtenção dos mapas temáticos, os dados foram geocodificados com auxílio do software MapInfo 7.8 e Spring 4.3. Os mapas temáticos ilustraram a distribuição da densidade de casos de dengue, hanseníase e tuberculose no município como uma maneira complementar de análise de informações de saúde, apontando as áreas prioritárias para o controle destas doenças.<br>The perception that some diseases happen in certain places is old. The concern in studying the relation between the human being and the environment resulted in several studies of medical geography, directed to the analysis of diseases spatial distribution. This sectional study was carried out in Ribeirão Preto, São Paulo State, and aimed to illustrate, through health problems (dengue, leprosy and tuberculosis), how a Geographic Information System tool allows the identification of heterogeneous areas, providing support for the choice of strategies and specific interventions according to the need of residents, as well as, priority of resources to more vulnerable groups. The population comprised cases of dengue, leprosy and tuberculosis notified in Ribeirão Preto in 2000. Data were collected in the Health Secretary Epidemiological Surveillance of the city. In order to obtain the thematic maps, data were geo-codified with the software MapInfo 7.8 e Spring 4.3. The thematic maps showed the density distribution of dengue, leprosy and tuberculosis cases in the city as a way to complement the analysis of health information, pointing priority areas for the control of these diseases